Bowel Cancer (Colorectal Cancer)

Cancers of the Colon and rectum are the second commonest cause of death from cancer in the western world. Around 30,000 new cases are diagnosed in England and Wales each year.

Predisposing Factors

• Genetically linked
• Polyposis (A group of several polyps)
• History of inflammatory bowel disease
• Previous history of carcinoma or adenoma

Risk Factors

• Obesity
• Sedentary lifestyle
• Smoking
• Age over 50
• Poor diet
• high calorie intake
• high protein intake
• high animal fat intake
• high alcohol consumption
• low fibre intake

The early stages of this type of cancer may not cause symptoms, but a change of bowel habit is the most common presenting feature. Other symptoms may include intermittent abdominal pain or blood in the stool. Anaemia may develop through hidden bleeding. Incomplete opening of the bowel or the feeling of wanting to continuously defecate may be a sign of rectal cancer.

Bowel cancer may be diagnosed in a number of different ways depending on the location of the tumour. A patient may present to his/her GP with symptoms as suggested above. An abdominal and rectal examination may reveal a palpable mass and this would merit an urgent referral to a specialist. Where symptoms have persisted for more than six weeks but no mass can be detected an urgent referral should still be made as the specialist will need to carry out further investigations to make a prompt and correct diagnosis. These investigations may include a colonoscopy or sigmoidoscopy which involves a flexible tube being inserted into the bowel. Any abnormality can be seen through a small camera and biopsies can be taken. An enema containing dye may also be used and this will show up any abnormalities on an x-ray. Following diagnosis urgent and correct management of the tumour is essential. Spread to the liver and lungs is a risk if diagnosis or treatment is delayed.

Surgery is the cornerstone of treatment. The tumour and affected part of the bowel can be removed. If this is undertaken promptly the risk of the tumour spreading will be reduced. Following surgery the pathology laboratory will stage the tumour and appropriate management of further treatment can be decided. This may include chemotherapy, radiotherapy or both.

Early presentation and diagnosis is critical to prevent spread of the tumour, therefore improving prognosis.

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